East Europe and North Asia
Countries
• Albania
• Armenia
• Azerbaijan
• Belarus
• Bosnia and Herzegovina
• Bulgaria
• Croatia
• Czech Republic
• Estonia
• Georgia
• Hungary
• Kazakhstan
• Kosovo
• Kyrgyzstan
• Latvia
• Lithuania
• Macedonia
• Moldova
• Montenegro
• Poland
• Romania
• Russia
• Serbia
• Slovakia
• Slovenia
• Tajikistan
• Turkmenistan
• Ukraine
• Uzbekistan
Health Risks
• Avian influenza
• Diphtheria (low risk)
• Malaria (in Azerbaijan)
• Tickborne encephalitis
• Tuberculosis
Preventing Health Problems
Recommended Vaccines
• Routine Vaccinations – including polio, measles-mumps-and-rubella (MMR), tetanus-diphtheria-and-pertussis (Tdap), and yearly influenza vaccines.
• Hepatitis A
• Hepatitis B (not necessary in Belarus)
• Typhoid (only recommended in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan)
• Rabies (only recommended in Armenia, Azerbaijan, Croatia, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan)
• Japanese encephalitis (only recommended in Russia)
• Polio (only recommended in Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan)
Avoiding Bug Bites
In Azerbaijan
• Malaria is a dangerous disease and is prevalent throughout this region of the world. It is very important to avoid and prevent bug bites while in this area due to the fact that malaria is spread by mosquitoes. There are some precautions that can be taken to prevent bug bites along with malaria.
o Anti-malaria prescription medications are available and are recommended. See a doctor prior to leaving about obtaining a prescription.
o To prevent bug bites use insect repellent with 30-50% DEET. In addition to insect repellent, wear long-sleeved shirts and pants. Since mosquitoes are more prevalent at night, avoid being outdoors during dusk and dawn as much as possible.
o Permethrin, while very effective against all insects, is especially effective against mosquitoes. By sleeping under permethrin-treated nets and using permethrin based insect spray indoors the amount of mosquitoes indoors can be reduced greatly.
In other areas of the region
• Mosquitoes, ticks, and other bugs can spread some diseases. You should use standard insect precautions:
o Use insect repellent with 30-50% DEET
o Wear long-sleeved shirts and pants when outdoors
Food and Water
• Being in a new culture also means new concerns about both food and water. In order to reduce food and water borne illnesses there are some simple things that can be done.
o Drink bottled water, bottled or canned carbonated drinks, or water you have filtered or treated. DO NOT drink tap water, fountain drinks, or use ice cubes.
o Washing your hands with soap and water or using an alcohol-based hand sanitizer before eating is a simple yet very effective way to reduce ingesting harmful bacteria and viruses.
o As for food, DO NOT eat food that may have contacted contaminated water or soil such as fresh vegetables or fruit that you don’t peel before eating.
o Meat should always be fully cooked before eating to avoid food borne illness as well as worms.
o DO NOT eat unpasteurized dairy products.
o Avoid eating food from street vendors as food borne illness is prevalent at them due to undercooked food and ingredients that are not properly washed.
Avoiding Injuries
• Some of the more common injuries that occur in these areas are bike injuries. Always wear a helmet while riding your bike.
• While less common, injuries do occur while driving. The best defense against injury while driving is wearing a seat belt at all times while in a car.
Avoiding Animals
• Animals such as dogs and cats can spread diseases and insects such as rabies and fleas. Avoid touching animals as much as possible.
Sun Exposure
• Too much sun exposure can increase your risk for getting skin cancer. Always wear sunscreen when outdoors.
Recommended Items to Bring
General Health and Medications
The following is a list of medications that you might consider taking to this area of the world.
• Any medications you take regularly at home
• Prescription anti-malarial medication (in Azerbaijan)
• Pain reliever such as ibuprofen, acetaminophen (Tylenol), or aspirin
• 1% hydrocortisone cream
• Anti-itch cream
• Antifungal cream
• Saline eye drops
• Anti motion sickness medication (if necessary)
• Thermometer
Avoiding Bug Bites
The following is a list of general items that you should take with you to prevent bug bites in this region.
In Azerbaijan
• Insect repellent with 30-50% DEET
• Long-sleeved shirts and pants
• Permethrin-treated bed netting and bedding
• Permethrin
o Currently, permethrin cannot be taken from the MTC in personal luggage on commercial airlines. You should plan on buying permethrin when you arrive in your mission or have it shipped out to you.
In other areas of the region
• Insect repellent with 30-50% DEET
• Long-sleeved shirts and pants
Food and Water
The following list includes items that help to simply reduce the spread of disease but also items that help to reduce water and food borne illness. There are also a couple medications that help in the event that you have diarrhea.
• Hand soap
• Alcohol-based hand sanitizer
• Water bottle
• Water purification
o Water filter
o Iodine tablets
o Ultraviolet water purifier
• Anti-diarrhea medication (loperamide)
• Bismuth subsalicylate (Pepto-Bismol)
• Prescription antibiotic to treat travelers’ diarrhea
Avoiding Injuries
This list includes items you should bring if you ride a bike as well as some of the items you should find in a first aid kit.
• Bicycle helmet
• Bicycle multi-tool
• Basic first aid kit
o Multiple sizes of adhesive bandages
o Antibiotic ointment
o Butterfly bandages
o Gauze pads
o Alcohol wipes
o Adhesive tape
o Blistoban
o Moleskin or Molefoam
o Burn treatment gel
o Tweezers
• Compression bandage
Sun Exposure
• Sunscreen and sunburn lotion such as aloe vera are both vital to prevent sun exposure and to treat sunburns.